Cataracts

Definition

A cataract is the clouding of the lens of the eye.  The crystalline lens is transparent and aids in focusing on the retina, the photosensitive tissue in the back of the eye. When the lens is cloudy from a cataract the image will be blurry.

While cataracts are usually associated with aging, there are other types of cataracts seen in children and adults.  They are listed below:

  • Congenital cataracts are from birth or develop in childhood.
  • Secondary cataracts develop after surgery for a different eye condition, i.e., glaucoma or cataracts that develop in people with other health problems, i.e., diabetes.
  • Traumatic cataracts develop after an eye injury and can occur several years later.
  • Developmental cataracts are from birth or develop during childhood
  • Radiation cataracts develop after exposure to radiation.

Some cataracts are so small they do not impact vision; others are large enough to cause vision loss.  At this time surgery is the only treatment for cataracts.    During surgery the cloudy lens is removed.  Many times it is replaced with an artificial lens called an “intraocular lens”.  The intraocular lens is able to move with the eye so there is no loss of side vision. When a lens has been removed and not replaced with an intraocular lens, the eye is described as aphakic, “without a lens”.  Individuals with aphakia may be prescribed eyeglasses or contact lenses.  Those with eyeglasses will need to turn their head in order to view objects on their side as eyeglasses are unable to accommodate for peripheral or side vision loss.

Functional Characteristics

The impact of congenital cataracts on vision depends on the location, size and density of the cataract.  Bilateral cataracts prohibit the development of the visual system in infants, especially if the cataract is in the center of the lens because of the decreased stimulation to the retina.
Infants with cataracts can also develop nystagmus (involuntary eye movements) or strabismus (turning in or out of the eye), which increases the risk of amblyopia (one eye becoming weaker than the other, or “lazy eye”). Due to the risk of amblyopia in children with congenital cataracts, they need to be monitored even after surgery.  Amblyopia is a major cause of visual impairment in young children with cataracts. Glaucoma is a not infrequent associated condition.

The lens protects the retina from ultraviolet light, so ultraviolet exposure should be kept to a minimum if an individual is aphakic. Protective lenses should be worn, and care should be taken when using a “black light”. It is best to avoid this type of lighting.  Without the lens, damage to the retina can occur. Other adaptations that can be helpful include:

 

  • Magnification or enlargement
  • Lighting from behind and minimize glare
  • Allow time for individual to adjust from one light source to another
  • Breaks to prevent visual fatigue
  • services of a Teacher of the Visually Impaired for adaptations and evaluation.

 

Associated Conditions

While cataracts can be inherited or occur in isolation, congenital cataracts often have additional associated conditions.   Cataracts can be

associated with syndromes such as Trisomy 21 (Down’s syndrome),  Marfan’s syndrome, Lowe syndrome, and Rieger syndrome. Cataracts can be caused by an intrauterine infection or can occur in infants with certain metabolic diseases.

 

Resources

National Eye Institute

National Institutes of Health

2020 Vision Place

Bethesda, MD 20892–3655

(301)496–5248

www.nei.nih.gov

 

Family Connect

A website for parents of children with visual impairments developed by American Foundation for the Blind and National Association of Parents of Children with Visual Impairments

www.familyconnect.org

 

Delta Gamma Center for Children with Visual Impairments

1750 S. Big Bend Blvd.

Richmond Heights, MO  63117

(314)776-1300

www.dgckids.org

 

 

Acknowledgements

Delta Gamma Center for Children with Visual Impairments acknowledges the following sources of information for this summary:

Eye Conditions & Syndromes & Other Conditions. Project VIISA; SKI-HI Institute

National Eye Institute. Facts about cataract. Retrieved November 23, 2010, from http://www.nei.nih.gov/health/cataract/cataract_facts.asp

Professional Edit, Steven D. Goodrich, M.D. Pediatric Ophthalmologist

 

 


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